3. A mixed methods evaluation of risk mitigation measures to address the dual public health crisis of COVID-19 and overdose

British Columbia is experiencing dual public health emergencies with escalating harms due to overdoses highlighting the need for innovative measures to support people who use substances. Our study examined implementation and impacts of a provincial prescriber-based 'safer supply' program, involving the prescription of alternatives to the toxic drug supply introduced in March 2020.

This mixed methods study is part of a larger provincial evaluation. Research activities include a 10- week prospective cohort study of people who have received or are seeking a prescription (n=200), and qualitative interviews with people who use substances (n=55). Surveys and interviews were designed to collect data on the impact of prescriptions on people’s health and wellness and the barriers and facilitators to program implementation. Activities were conducted simultaneously, with convergent analysis of data.

During COVID 19, prescriber safer supply was introduced but not widely implemented in BC. Participants highlighted the difficulties of finding a prescriber and the difficulties of accessing the right drugs and dosing outside of select community-based programs. Participants described multiple outcomes they deemed important beyond withdrawal and overdose such as regaining relationships, hustling less, and having time for other activities. Implementation challenges included requirements related to daily dispensing, witnessing and pick-up.

Through a strong collaboration between academic and community researchers, we are generating evidence to support effective policy and practice. This evidence is much needed as BC continues to respond to COVID-19, while entering the sixth year of a public health overdose emergency.

Disclosure of interest statement: This work was supported by Canadian Institutes of Health Research and Victoria Hospital Foundation